Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada.
Br J Sports Med. 2019 Jan;53(2):124-133. doi: 10.1136/bjsports-2018-099822. Epub 2018 Oct 18.
To perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics.
Systematic review with random-effects meta-analysis and meta-regression.
Online databases were searched up to 6 January 2017.
Studies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ["exercise-only"] or in combination with other intervention components [eg, dietary; "exercise + co-intervention"]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcomes (FHR, beats per minute (bpm); uterine and umbilical blood flow metrics (systolic:diastolic (S/D) ratio; Pulsatility Index (PI); Resistance Index (RI); blood flow, mL/min; and blood velocity, cm/s)).
'Very low' to 'moderate' quality evidence from 91 unique studies (n=4641 women) were included. Overall, FHR increased during (mean difference (MD)=6.35bpm; 95% CI 2.30 to 10.41, I=95%, p=0.002) and following acute exercise (MD=4.05; 95% CI 2.98 to 5.12, I=83%, p<0.00001). The incidence of fetal bradycardia was low at rest and unchanged with acute exercise. There were no significant changes in umbilical or uterine S/D, PI, RI, blood flow or blood velocity during or following acute exercise sessions. Chronic exercise decreased resting FHR and the umbilical artery S/D, PI and RI at rest.
Acute and chronic prenatal exercise do not adversely impact FHR or uteroplacental blood flow metrics.
系统评价和荟萃分析检查急性和慢性产前运动对胎儿心率（FHR）和脐血流及子宫血流指标的影响。
系统评价，随机效应荟萃分析和荟萃回归。
在线数据库搜索至 2017 年 1 月 6 日。
所有设计的研究均被纳入（除病例研究），如果以英文、西班牙语或法语发表，且包含人群信息（无运动禁忌的孕妇）、干预措施（频率、强度、持续时间、运动量或运动类型的主观或客观测量，单独进行[“运动仅”]或与其他干预措施联合进行[如饮食；“运动+联合干预”]）、比较组（无运动或不同频率、强度、持续时间、运动量和运动类型）和结局（FHR，每分钟跳动次数（bpm）；子宫和脐血流指标（收缩期/舒张期（S/D）比值；搏动指数（PI）；阻力指数（RI）；血流量，mL/min；和血流速度，cm/s）。
纳入了 91 项独特研究（n=4641 名妇女）的“极低”至“中等”质量证据。总体而言，FHR 在急性运动期间（平均差异（MD）=6.35bpm；95%CI 2.30 至 10.41，I=95%，p=0.002）和之后增加（MD=4.05；95%CI 2.98 至 5.12，I=83%，p<0.00001）。在休息时胎儿心动过缓的发生率较低，而急性运动后则没有变化。在急性运动期间或之后，脐动脉或子宫 S/D、PI、RI、血流量或血流速度没有明显变化。慢性运动降低了休息时的 FHR 和脐动脉 S/D、PI 和 RI。
急性和慢性产前运动不会对 FHR 或胎盘血流指标产生不利影响。
